Accuracy and precision of low-dose insulin administration

S. J. Casella, M. K. Mongilio, L. P. Plotnick, M. P. Hesterberg, C. A. Long

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. To determine the lowest dose of concentrated (U100) insulin that can be reproducibly delivered. Methods. A telephone survey was used to determine current practices in major pediatric hospitals regarding the administration of low doses of concentrated insulin. A sensitive gravitometric technique was used to determine the error in measurement of low doses of U100 insulin by pediatric nurses and parents of diabetic children. Results. A telephone survey revealed that doses as low as 0.5 or 1.0 U (5 to 10 μL) are routinely administered in pediatric hospitals. In our study of pediatric nurses, attempts to deliver 0.5, 1.0, and 2.0 U resulted in delivered doses of 0.975 ± 0.315, 1.638 ± 0.376, and 2.153 ± 0.435 U (mean ± standard deviation of the mean), respectively. The use of 0.3-mL syringes compared to 0.5-mL syringes did not improve accuracy or precision. Taken as a group, parents of children with diabetes were more accurate (mean delivered dose of 1.063 ± 0.276 for the 1-U dose), but the individual means ranged from 0.641 to 1.300 and coefficients of variation ranged from 5% to 33%. Only three of the seven parents could deliver 1.0 U with acceptable precision and accuracy. Conclusions. When currently available syringes are used, insulin injections of less than 20 μL (2 U of U100) have an unacceptably large error. It is recommended that, in the inpatient setting, diluted insulin be used if the prescribed dose is less than 2.0 U.

Original languageEnglish (US)
Pages (from-to)1155-1157
Number of pages3
JournalPediatrics
Volume91
Issue number6
StatePublished - Jan 1 1993

Keywords

  • diabetes mellitus
  • insulin
  • medication errors
  • syringes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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